Guidelines for Otitis Externa and Discharging Ear Secondary to Grommets

Step 1

• Dry mopping prior to topical drops.
• Use of cotton buds permitted with caution.

Step 2

• Suction if available - syringing is often painful.

Step 3

• If the ear canal is closed, then use Otowick.

Step 4

• Topical agents
  • First choice - Sofradex, Chloromycetin 3 drops TDS
  • Second line - Maxitrol, Tobarax, Ciproxin HC 3 drops TDS
  • Fungal - Locorten Vioform or Kenacomb

Step 5

• Oral antibiotics is sometimes useful - recurrent upper respiratory tract infection

Step 6

• Microbiological (MCS) ear swab if no improvement after five days of treatment

Step 7

• Vosol is a good washing agent to remove debris / pus but can sting.
• Use with caution in perforation and grommets - 3 drops BD

Step 8

• Diluted hydrogen peroxide 3% diluted 50:50 with saline is also a good debris removal solution.
• Use with caution when perforated or grommets - 5 drops BD